Compositions and methods for transplantation of colon microbiota
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example 1
[0060]Clostridium difficile associated disease is a major known complication of antibiotic therapy. The pathogen is normally held in check by native colon microbiota, but this level of protection may be lost when these microbial communities are suppressed by antibiotics. Antibiotics used to treat C. difficile infection may also perpetuate its recurrence by continued suppression of normal microbiota. Thus, a significant fraction of patients suffer from recalcitrant C. difficile infection, and recalcitrant C. difficile infection is associated with significant morbidity. Fecal bacteriotherapy is an increasingly used method used to break the cycle of C. difficile infection recurrence presumably through restoration of normal intestinal microbial communities. We previously reported, in one clinical case, that bacteriotherapy of colon microbota resulted in the replacement of a host's microbiota by that of the donor (Khoruts, et al., 2010, J. Clin. Gastroenterol., 44(5):354). In order to ob...
example 2
Donor Screening for Fecal Microbiota Material Preparation
[0080]The donor undergoes a complete medical history and physical examination. In addition, a full-length donor history questionnaire is completed as recommended by the FDA for blood donors, and potential donors saying yes to any of the questions are excluded (http: / / www.fda.gov / downloads / BiologicsBloodVaccines / BloodBloodProducts / ApprovedProducts / LicensedProductsBLAs / BloodDonorScreening / UCM213552.pdf). However, as gut microbiota have been associated or postulated to be involved with multiple medical conditions, the process of selection is more rigorous than that of the blood donors and includes virtually any systemic illness.
Inclusion Criteria
[0081]1. Age >18[0082]2. Ability to provide informed consent.
[0083]Exclusion Criteria
[0084]I. Medical History[0085]A. Risk of infectious agent.[0086]1. Known viral infection with Hepatitis B, C or HIV[0087]2. Known exposure to HIV or viral hepatitis at any time[0088]3. High risk behaviors...
example 3
Fecal Sample Processing
[0131]Donor fecal material is immediately chilled on ice for transport to the laboratory. Samples are processed within one hour after collection.
[0132]Fecal samples are homogenized by mixing 50 g of donor feces and 250 ml of sterile phosphate buffered saline, pH 7, (PBS) in a Waring Blender. The blending chamber is purged with nitrogen gas for several minutes to remove oxygen prior to homogenization. Samples are blended three times on the lowest setting for 20 seconds. Additional PBS or blending cycles may be added depending on the consistency of the fecal suspension. Blended samples are passed through a series of four sieves with pore sizes of 2.0 mm, 1.0 mm, 0.5 mm and 0.25 mm (W.S. Tyler Industrial Group, Mentor, Ohio). The sieves were based on US standard sieve sizes of 10, 18, 35, and 60 for 2.0 mm, 1.0 mm, 0.5 mm and 0.25 mm, respectively. The final filtrate passing through the sieves (less than 0.25 mm fraction) is collected in 50 ml conical centrifuge ...
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